| Desilva Medical, Inc. | |
|
623 W Avenue Q Suite A Palmdale CA 93551-3890 | |
| (661) 726-6255 | |
| (661) 726-6261 |
| Full Name | Desilva Medical, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 623 W Avenue Q, Palmdale, California |
| Authorized Official Name and Position | Pamela D. Desilva (OWNER) |
| Authorized Official Contact | 6617266255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desilva Medical, Inc. Po Box 4037 Lancaster CA 93539-4037 Ph: (661) 726-6255 | Desilva Medical, Inc. 623 W Avenue Q Suite A Palmdale CA 93551-3890 Ph: (661) 726-6255 |
| NPI Number | 1528249802 |
|---|---|
| Provider Enumeration Date | 11/15/2007 |
| Last Update Date | 01/05/2012 |
| Medicare PECOS PAC ID | 6103903570 |
|---|---|
| Medicare Enrollment ID | O20080409000416 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528249802 | NPI | - | NPPES |
| 00A488940 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A48894 (California) | Primary |
| Provider Name | Pamela D Desilva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568414548 PECOS PAC ID: 3375623309 Enrollment ID: I20080103000494 |
| Provider Name | Diana Aurora Uribe-tanus |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1780069054 PECOS PAC ID: 1254648819 Enrollment ID: I20150916001881 |
| Provider Name | May Chong Finley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073976528 PECOS PAC ID: 4284032616 Enrollment ID: I20211014002338 |
| Provider Name | Shahla Khan |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1548513567 PECOS PAC ID: 1153786660 Enrollment ID: I20230504001895 |
| Provider Name | Cecilia Jane Fisher |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1457060634 PECOS PAC ID: 1456713437 Enrollment ID: I20230809000668 |
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